Circular No. 01/2025/TT-BYT provides detailed guidance on the implementation of certain provisions of the Health Insurance Law concerning the organization of initial health insurance medical examination and treatment, registration for medical examination, transfer between medical facilities, rescheduling procedures, and transfer records. It applies to health insurance participants, health insurance medical examination and treatment facilities, and related entities.

 

CIRCULAR

Detailed regulations and guidance on implementing certain provisions of the Health Insurance Law

Pursuant to the Health Insurance Law dated November 14, 2008, the Law Amending and Supplementing Certain Provisions of the Health Insurance Law dated June 13, 2014, and the Law Amending and Supplementing Certain Provisions of the Health Insurance Law dated November 27, 2024;

Pursuant to Decree No. 95/2022/NĐ-CP dated November 15, 2022 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

At the proposal of the Director of the Health Insurance Department, Ministry of Health,

The Minister of Health issues this Circular detailing and guiding the implementation of certain provisions of the Health Insurance Law.

Article 1. Scope of Regulation

1. This Circular details and guides the implementation of certain provisions of the Health Insurance Law number 25/2008/QH12 dated November 14, 2008, which has been amended and supplemented with certain provisions by Laws number 32/2013/QH13, number 46/2014/QH13, number 97/2015/QH13, number 35/2018/QH14, number 68/2020/QH14, number 30/2023/QH15, and number 51/2024/QH15 (hereinafter referred to as the Health Insurance Law), including:

a) Regulations on the organizational form of health care for agencies, units, and organizations under primary healthcare facilities as stipulated at point c, Clause 1, Article 22 of the Health Insurance Law;

b) Regulations on residence, procedures for examination and treatment under health insurance at Clause 3, Article 22 of the Health Insurance Law;

c) Regulations on diagnosis confirmation, treatment of rare diseases, serious illnesses, or surgeries requiring high-tech techniques as stipulated at point a, Clause 4, Article 22 of the Health Insurance Law;

d) Detailed regulations on registration for primary health insurance examination and treatment and allocation of health insurance card quantities for primary health insurance examination and treatment facilities as stipulated at Clauses 1 and 2, Article 26 of the Health Insurance Law;

e) Regulations on registration for primary health insurance examination and treatment at specialized deep-level healthcare facilities as stipulated at Clause 3, Article 26 of the Health Insurance Law;

f) Regulations on patient transfer between healthcare facilities as stipulated at Clause 1, Article 27 of the Health Insurance Law;

g) Regulations on transferring patients back to primary health insurance examination and treatment facilities for chronic disease management as stipulated at Clause 2, Article 27 of the Health Insurance Law;

h) Regulations on rescheduling examinations according to professional requirements during health examination and treatment as stipulated at Clause 2, Article 28 of the Health Insurance Law;

i) Regulations on the transfer file between healthcare facilities as stipulated at Clause 3, Article 28 of the Health Insurance Law.

2. Amend, supplement, and abolish relevant provisions related to levels and categories in some Circulars issued by the Minister of Health.

Article 2. Scope of Application

1. This Circular applies to individuals participating in health insurance, health insurance examination and treatment facilities, and related organizations and individuals, including the following cases:

a) Health insurance examination and treatment facilities under the jurisdiction of the Ministry of National Defense and the Ministry of Public Security registering primary health insurance examination and treatment for subjects not under their jurisdiction;

b) Individuals participating in health insurance under the jurisdiction of the Ministry of National Defense and the Ministry of Public Security registering primary health insurance examination and treatment at health insurance examination and treatment facilities not under their jurisdiction;

c) Individuals participating in health insurance not under the jurisdiction of the Ministry of National Defense and the Ministry of Public Security registering primary health insurance examination and treatment at health insurance examination and treatment facilities under the jurisdiction of the Ministry of National Defense and the Ministry of Public Security;

d) Cases involving the transfer of patients between health insurance examination and treatment facilities under the jurisdiction of the Ministry of National Defense and the Ministry of Public Security and those not under their jurisdiction.

2. This Circular does not apply to the following cases:

a) Registration for primary health insurance examination and treatment of subjects under the jurisdiction of the Ministry of National Defense and the Ministry of Public Security at health insurance examination and treatment facilities under their jurisdiction;

b) Transfer of patients under the jurisdiction of the Ministry of National Defense and the Ministry of Public Security between health insurance examination and treatment facilities under their jurisdiction.

Article 3. Provisions on the organizational form of workplace health services at the primary healthcare level as stipulated in point c, Clause 1, Article 22 of the Health Insurance Law.

Workplace health services at the primary healthcare level include the health services of state agencies, public institutions, production and business establishments, educational facilities, and other organizations that are organized in the form of health stations or clinics contracted to provide health insurance medical examinations and treatments.

Article 4. Cases of temporary residence and procedures for health insurance medical examinations and treatments as stipulated in Clause 3, Article 22 of the Health Insurance Law.

1. The cases of temporary residence eligible for health insurance medical examinations and treatments as stipulated in Clause 3, Article 22 of the Health Insurance Law refer to situations where health insurance participants change their place of residence for less than 30 days and have reported their temporary residence information in accordance with the law on residence registration, including:

a) Individuals traveling on official business to another province or centrally governed city (hereinafter referred to as "province");

b) Students studying in another province during summer, holiday, or festival breaks at home or during practical training periods in another province;

c) Workers taking leave at home in another province;

d) Individuals working temporarily in another province;

đ) Individuals visiting family members in another province as provided for in Clause 16, Article 3 of the Marriage and Family Law.

2. Procedures for health insurance medical examinations and treatments when changing places of temporary residence are carried out as follows:

a) Health insurance participants who fall under the cases of changing places of temporary residence as stipulated in Clause 1 of this Article and those changing places of temporary residence shall follow the procedures prescribed in Article 28 of the Health Insurance Law and Article 15 of Decree No. 146/2018/NĐ-CP dated October 17, 2018 of the Government detailing and guiding methods to implement certain provisions of the Health Insurance Law;

b) In cases of changing places of temporary residence as stipulated in Clause 1 of this Article, health insurance participants must also comply with the procedures prescribed in Clause 3 of this Article;

c) In cases of changing places of temporary residence, health insurance participants must also comply with the procedures prescribed in Clause 4 of this Article.

3. In cases of changing places of temporary residence as stipulated in Clause 1 of this Article, health insurance participants must present to health insurance medical examination and treatment facilities documents regarding changes in their place of temporary residence as follows:

a) Dispatch orders for official travel and updated residence information on Level 2 electronic identity accounts on the VNeID application for the case stipulated in point a, Clause 1 of this Article;

b) Student identification cards and updated residence information on Level 2 electronic identity accounts on the VNeID application for the case stipulated in point b, Clause 1 of this Article;

c) Leave certificates from the managing agency or unit confirmed by the participant's employer and updated residence information on Level 2 electronic identity accounts on the VNeID application for the case stipulated in point c, Clause 1 of this Article;

d) Dispatch orders or task assignments for temporary work from the managing agency or unit confirmed by the participant's employer and updated residence information on Level 2 electronic identity accounts on the VNeID application for the case stipulated in point d, Clause 1 of this Article;

đ) Documents showing family relationships according to marriage and family laws and updated residence information on Level 2 electronic identity accounts on the VNeID application for the case stipulated in point đ, Clause 1 of this Article.

4. In cases of changing places of temporary residence, health insurance participants must present to health insurance medical examination and treatment facilities one of the following documents proving changes in their place of temporary residence: temporary residence registration receipt or notification from the competent authority confirming the update of temporary residence registration information or temporary residence registration information on Level 2 electronic identity accounts on the VNeID application.

Article 5. Cases where a definitive diagnosis is made for certain rare diseases, serious illnesses, diseases requiring surgery, or the use of advanced techniques as specified in point a, Clause 4, Article 22 of the Health Insurance Law.

1. The Circular hereby promulgates the lists of certain rare diseases, serious illnesses, diseases requiring surgery, or the use of advanced techniques entitled to 100% benefit level as stipulated in point a, Clause 4, Article 22 of the Health Insurance Law, as follows:

a) List of certain diseases eligible for medical examination and treatment at specialized healthcare facilities as prescribed in Appendix I;

b) List of certain diseases eligible for medical examination and treatment at basic healthcare facilities as prescribed in Appendix II.

2. Participants in health insurance under the cases stipulated in Clause 1 of this Article are not required to comply with the regulations on transferring healthcare facilities.

3. Health insurance participants shall enjoy the benefits as prescribed in Clauses 1 and 2 of this Article according to the following provisions:

a) Patients shall be entitled to benefits after being definitively diagnosed with a disease listed in Clause 1 of this Article by one healthcare facility. In cases where the patient's condition or status in the disease list attached to this Circular specifies that the patient is entitled to benefits immediately during the medical examination and treatment session resulting in a definitive diagnosis, then the patient shall be entitled to such benefits immediately.

- Example 1: In Appendix I, pancreatic cancer - code C25, the patient is entitled to the following:

Case 1: If the patient has been initially or basically diagnosed with pancreatic cancer - code C25 at Hospital A, they can directly seek medical examination and treatment for pancreatic cancer - code C25 at Hospital B, a specialized healthcare facility, and enjoy the benefits as stipulated in this Article.

Case 2: If the patient directly seeks medical examination and treatment for pancreatic cancer - code C25 at Hospital B, a specialized healthcare facility, and is definitively diagnosed with pancreatic cancer - code C25 at Hospital B, then the patient will enjoy the benefits as stipulated in this Article immediately during this medical examination and treatment session at Hospital B for diagnosing and treating pancreatic cancer - code C25.

- Example 2: If the patient is definitively diagnosed with pancreatic cancer - code C25 at Hospital A, a primary or basic healthcare facility, and subsequently seeks medical examination and treatment at Hospital B, a specialized healthcare facility, then the patient is entitled to the following benefits as stipulated in this Article:

Case 1: If Hospital B definitively diagnoses the patient with pancreatic cancer - code C25, the patient will enjoy the benefits as stipulated in this Article for the medical examination and treatment of pancreatic cancer - code C25 at Hospital B. During the medical examination and treatment of pancreatic cancer - code C25 at Hospital B, if other diseases or accompanying conditions are discovered, the patient will also be reimbursed for the costs of examining and treating those diseases or conditions within the scope and level of benefits prescribed by the law on health insurance for cases complying with the procedures and formalities stipulated by the law on health insurance.

Case 2: If Hospital B definitively diagnoses the patient as not having pancreatic cancer - code C25, the patient still enjoys the benefits as stipulated in this Article for the medical examination and diagnosis at Hospital B.

Case 3: When seeking medical examination and treatment for pancreatic cancer - code C25 at Hospital B, if the patient requests additional medical examination and treatment for other diseases, they will only enjoy the benefits as stipulated in this Article for the medical examination and treatment of pancreatic cancer - code C25 at Hospital B and will not enjoy the benefits as stipulated in this Article for the additional medical examination and treatment of other diseases at Hospital B.

b) In cases where the disease in the appendices specifies conditions or disease states, the patient will only be entitled to benefits when meeting those conditions or disease states.

4. In cases where the name of the diagnosed disease does not completely match the name of the disease, disease group, or cases specified in the appendices issued along with this Circular but the disease code matches, the application shall be unified based on the disease code.

5. In cases where the patient has been stably treated or due to professional requirements, disease status, or healthcare facility conditions, the patient may be transferred back to a basic or initial healthcare facility for continued monitoring and treatment.

Article 6. Primary Medical Examination and Treatment Insurance Facilities

1. Primary medical examination and treatment insurance facilities at the primary level that are registered to provide primary medical examination and treatment insurance services for insured persons according to Clause 1, Article 7 of this Circular include:

a) Health Stations;

b) Health facilities of agencies licensed to operate medical examinations and treatments under one of the forms specified in Points a, c, e, g, and h of this Clause;

c) Polyclinics;

d) Regional Polyclinics;

đ) District-level Health Centers licensed to operate medical examinations and treatments in the form of polyclinics as stipulated in Points c or h of this Clause;

e) Family Medicine Examination and Treatment Facilities licensed to operate medical examinations and treatments in the form of polyclinics;

g) Doctor Clinics or Multidisciplinary Clinics located in communes within areas with extremely difficult socio-economic conditions;

h) Other medical examination and treatment facilities specializing in internal medicine and at least one of the following specialties: surgery, pediatrics, obstetrics, not organized in the forms of specialized clinics, multi-specialty clinics, dental clinics, nutrition clinics, midwifery houses, traditional Chinese medicine clinics, diagnostic laboratories, imaging centers, dental restoration centers, rehabilitation centers, dialysis centers, clinical psychology centers, nursing service centers, midwifery service centers, palliative care centers, out-of-hospital emergency centers, and optical centers conducting refractive error tests and examinations.

2. Primary medical examination and treatment insurance facilities at the basic level that are registered to provide primary medical examination and treatment insurance services for certain insured persons according to Clause 2, Article 7 of this Circular include:

a) Medical examination and treatment facilities licensed to operate in the form of general hospitals;

b) Medical examination and treatment facilities licensed to operate in one of the following forms: specialized hospitals, traditional Chinese medicine hospitals, or dental hospitals. The organizational structure of these facilities must have a specialized department in the form of a department, center, or institute. This specialized department must have internal medicine and at least one of the following specialties: surgery, pediatrics, obstetrics.

3. Primary medical examination and treatment insurance facilities at the advanced level that are registered to provide primary medical examination and treatment insurance services for certain insured persons according to Clause 3, Article 7 of this Circular include:

a) Medical examination and treatment facilities specified in Points a and b of Clause 2 of this Article that were recognized by competent authorities as district or provincial levels or equivalent before January 1, 2025;

b) Medical examination and treatment facilities with functions of protecting the health of officials, leprosy, tuberculosis, and lung disease hospitals, mental health hospitals, geriatric hospitals, and traditional Chinese medicine hospitals, which have a specialized department in the form of a department, center, or institute. This specialized department must have internal medicine and at least one of the following specialties: surgery, pediatrics, obstetrics;

c) Other medical examination and treatment facilities as decided by the Ministry of Health, which have a specialized department in the form of a department, center, or institute. This specialized department must have internal medicine and at least one of the following specialties: surgery, pediatrics, obstetrics.

Article 7. Registration for initial health check-up and treatment under health insurance

1. Participants in health insurance from all categories shall choose one of the health check-up and treatment facilities under the primary level of health care as prescribed in Clause 1, Article 6 of this Circular that are near their place of residence, work, study, and capable of meeting the needs of such participants to register for initial health check-up and treatment under health insurance.

2. Participants in health insurance may register for initial health check-up and treatment under health insurance at one of the health check-up and treatment facilities under the basic level of health care as prescribed in Clause 2, Article 6 of this Circular that are near their place of residence, work, study, and capable of meeting the needs of such facilities in the following priority order:

a) Subjects under the management and health protection according to Guideline No. 52/HDBTCTW dated December 2, 2005 of the Central Organization Committee of the Communist Party of Vietnam on adjusting and supplementing the subjects for health check-up and treatment at some central medical facilities; subjects under the management and health protection of provincial cadres;

b) Persons with meritorious service to the revolution, former soldiers, persons aged 75 years or older;

c) Children;

đ) Students, trainees, and learners of universities, colleges, and secondary vocational schools in the health sector may register for initial health check-up and treatment at health check-up and treatment facilities of their schools that have signed contracts for health check-up and treatment in compliance with the provisions of Clause 2, Article 6 of this Circular; workers of health check-up and treatment facilities under health insurance may register for initial health check-up and treatment at the health check-up and treatment facilities where they work that have signed contracts for health check-up and treatment in compliance with the provisions of Clause 2, Article 6 of this Circular;

e) Students, trainees, and learners studying, practicing, or interning at health check-up and treatment facilities under health insurance for at least 90 days may register for initial health check-up and treatment at the health check-up and treatment facilities where they are studying, practicing, or interning that have signed contracts for health check-up and treatment in compliance with the provisions of Clause 2, Article 6 of this Circular; workers who travel to health check-up and treatment facilities under health insurance for at least 90 days may register for initial health check-up and treatment at the health check-up and treatment facilities where they are traveling that have signed contracts for health check-up and treatment in compliance with the provisions of Clause 2, Article 6 of this Circular;

g) Persons working in the military or police upon retirement;

h) Persons suffering from diseases requiring long-term treatment according to the list of the Ministry of Health;

i) Civil servants, public officials, students outside the cases stipulated in point đ of this clause;

k) Other subjects.

3. Participants in health insurance may register for initial health check-up and treatment at one of the health check-up and treatment facilities under the specialized level of health care as prescribed in Clause 3, Article 6 of this Circular that are near their place of residence, work, study, and capable of meeting the needs of such facilities in the following priority order:

a) Subjects managed by the Politburo and the Secretariat;

b) Subjects prescribed in point a of Clause 2 of this Article;

c) Persons with meritorious service to the revolution, former soldiers, persons aged 75 years or older;

d) Subjects prescribed in points đ and e of Clause 2 of this Article;

đ) Children under six years old;

e) Persons working in the military or police upon retirement;

g) Persons suffering from diseases requiring long-term treatment according to the list of the Ministry of Health at one of the health check-up and treatment facilities prescribed in point b of Clause 3 of this Article;

h) Other subjects in special cases according to the characteristics of the health check-up and treatment facilities and actual requirements at the locality: The Department of Health collects opinions from the Social Insurance Office of the province where the health check-up and treatment facilities intend to sign contracts for health check-up and treatment, compiles the dossier, and reports to the Ministry of Health for consideration and decision.

4. In case participants in health insurance belong to multiple priority subjects as prescribed in Clauses 2 and 3 of this Article, they may choose according to the most suitable subject.

5. Retired personnel from the military or police may choose to register for initial health check-up and treatment at health check-up and treatment facilities under the management of the Ministry of National Defense or the Ministry of Public Security according to the regulations of the Minister of National Defense and the Minister of Public Security.

6. Changes to the initial registration location shall be carried out as follows:

a) Participants in health insurance may change their initial registration location for health check-up and treatment under health insurance within the first 15 days of each quarter to suit their place of residence, work, or study;

b) The Social Insurance Agency shall implement changes to the initial registration location for health check-up and treatment under health insurance of participants in health insurance based on the data in the health insurance card. In case the information on the paper version of the health insurance card differs from the electronic version, the information on the electronic health insurance card shall prevail.

Article 8. Allocation of health insurance cards to primary healthcare facilities under health insurance

1. Principles for allocating the number of health insurance cards to primary healthcare facilities under health insurance shall comply with the provisions stipulated in Clause 2, Article 26 of the Health Insurance Law, specifically as follows:

a) Ensuring balance and suitability with the demand for primary healthcare services under health insurance of the population and the provisions of Article 7 of this Circular;

b) Being consistent with the capacity of primary healthcare facilities under health insurance to provide primary healthcare services, multi-disciplinary medical care, and initial emergency treatment, the number of medical consultations and treatments annually, the number of patients per consultation desk per day, operational conditions regarding infrastructure, human resources, drug supply, equipment according to the laws on medical examination and treatment, bed capacity (if applicable), and the provisions of Article 6 of this Circular;

c) Consistent with the actual situation at the local level including: balancing the number of primary healthcare facilities under health insurance, among primary healthcare facilities under health insurance within each technical specialty level, and between different technical specialty levels within the locality; prioritizing the allocation of health insurance cards to primary healthcare facilities; ensuring reasonable balance and structure among groups participating in health insurance.

2. The Department of Health shall have the following responsibilities:

a) Implementing a stable allocation of the number of health insurance cards to primary healthcare facilities under health insurance within its jurisdiction;

b) Reviewing and adjusting the number of health insurance cards of healthcare facilities and among healthcare facilities when necessary to ensure compliance with this Circular or when participants in health insurance register anew or request changes to their registration of primary healthcare facilities under health insurance;

c) Publicly announcing the number of health insurance cards allocated to healthcare facilities on the Department of Health's website.

3. Social Insurance Agencies shall have the following responsibilities:

a) Before October 31 of each year, social insurance agencies shall provide information on the actual number and structure of participants in health insurance who have registered, to the Department of Health and healthcare facilities; information on the number of health insurance medical consultations and treatments and transfers between healthcare facilities under health insurance within the province to the Department of Health as a basis for considering and organizing the allocation of health insurance cards to primary healthcare facilities under health insurance within its jurisdiction;

b) Organizing for participants in health insurance to register for primary healthcare services under health insurance and change their registration of primary healthcare facilities under health insurance at primary healthcare facilities under health insurance according to this Circular;

c) Announcing information about the number of health insurance cards that participants have registered at healthcare facilities to the Department of Health for consolidation, timely review, and adjustment of the number of health insurance cards of healthcare facilities and among healthcare facilities when necessary, on a monthly basis at the end of the first month of each quarter;

d) Publicly posting information about the actual number and structure of participants in health insurance who have registered at healthcare facilities within the province on the social insurance agency's website.

4. The Ministry of National Defense and the Ministry of Public Security shall be responsible for compiling needs and issuing written notifications to the Department of Health and social insurance agencies within the province to consolidate information and allocate in cases specified in points a, b, and c of Clause 1, Article 2 of this Circular.

Article 9. Transfer of patients between healthcare facilities providing health insurance medical services

1. The transfer of patients between healthcare facilities providing health insurance medical services shall be carried out in accordance with the provisions of the law on medical examination and treatment.

2. The cases of transferring patients between healthcare facilities providing health insurance medical services according to the correct procedure include:

a) Transferring patients between healthcare facilities providing health insurance medical services within the same level of medical examination and treatment, from primary healthcare facilities to basic healthcare facilities, from basic healthcare facilities to specialized healthcare facilities based on professional requirements, patient condition, or exceeding the capacity of the healthcare facility outside the cases specified in point đ Clause 1 of this Article and Article 5 of this Circular;

b) Transferring patients from primary healthcare facilities to specialized healthcare facilities in cases where the basic healthcare facilities at the province level cannot meet the needs;

c) Transferring patients who have been stably treated from specialized healthcare facilities back to basic healthcare facilities or primary healthcare facilities, transferring patients from basic healthcare facilities back to primary healthcare facilities for continued treatment and monitoring;

d) Transferring patients from specialized healthcare facilities or basic healthcare facilities back to initial healthcare facilities providing health insurance medical services for treatment, management, and monitoring of chronic diseases as prescribed in Article 10 of this Circular;

đ) Transferring patients between healthcare facilities in cases of chronic diseases or long-term treatment according to the list of diseases stipulated in Appendix III issued together with this Circular, the referral form for healthcare facilities has a validity of one year from the date recorded on the referral form and shall be implemented in accordance with point b Clause 3, Clause 4, and Clause 5 of Article 5 of this Circular;

e) In cases where individuals with health insurance cards go to seek medical examination and treatment without following the provisions of Article 26 and Article 27 of the Health Insurance Law and fall under the cases specified in points e, g, h (excluding cases entitled to 100% benefits at points e and h) Clause 4 of Article 22 of the Health Insurance Law, they may then be transferred to other healthcare facilities according to professional requirements;

g) In emergency cases, after the emergency treatment phase, patients can be transferred for inpatient treatment at the healthcare facility that initially received them for emergency care or transferred to another healthcare facility for continued treatment according to professional requirements or transferred back to their registered initial healthcare facility after stable treatment;

Article 10. Transfer of patients to initial healthcare facilities providing health insurance medical services for treatment, management, and monitoring of chronic diseases

1. After being stably treated for chronic diseases listed in Appendix IV issued together with this Circular, healthcare facilities may transfer patients to initial healthcare facilities where patients have registered for health insurance medical services for continued treatment, management, and monitoring;

2. Initial healthcare facilities where patients have registered for health insurance medical services shall implement treatment, management, and monitoring of chronic diseases in accordance with professional guidelines of the Ministry of Health and the following regulations:

a) Conduct medical examinations according to the referral file; issue medications and medical equipment within the scope of payment by the Health Insurance Fund periodically according to the referral file. The regular check-up prescribed herein counts as one medical examination;

b) In cases where patients develop new illnesses or symptoms requiring medical examination, service provision, medication prescription, and medical equipment designation, initial healthcare facilities shall perform these tasks within their professional capabilities, scope of activities, and approved technical service lists, or refer patients to other healthcare facilities providing health insurance medical services in accordance with the law;

3. The Health Insurance Fund shall settle costs for medical examinations and treatments including consultation fees, medication costs, medical equipment, and technical services prescribed within the professional capabilities of the facility managing and monitoring chronic diseases as stipulated in Clause 1 and Clause 2 of this Article, regulations on medication reimbursement, medical equipment, technical services, and other relevant regulations on medical examination and treatment within the scope of benefits and entitlements as prescribed by the Health Insurance Law;

4. Healthcare facilities managing chronic patients shall establish plans, purchase supplies according to regulations, or receive medications and medical equipment distributed or transferred from the facility that referred the patient, manage and consolidate medical examination and treatment costs, medications, medical equipment, technical services, and settle accounts with social insurance agencies;

5. Healthcare facilities providing health insurance medical services that transfer patients for management, monitoring, and treatment at initial healthcare facilities where patients have registered for health insurance medical services shall bear the following responsibilities:

a) Coordinate and exchange information with receiving facilities to ensure supply of medications and medical equipment and not affect the treatment process of patients;

b) Transfer medications and medical equipment during the period when the receiving healthcare facility does not have sufficient stock to provide to patients.

Article 11. Rescheduling for Follow-up Appointments

In cases where it is necessary to continue monitoring the patient's condition or rechecking the results of the previous examination and treatment according to professional requirements, the healthcare facility providing health insurance medical services shall reschedule the follow-up appointment in accordance with the following procedures:

1. The healthcare facility shall record the content and schedule of the rescheduled appointment on the Follow-up Appointment Form (in paper or electronic form) in accordance with the model prescribed in Appendix V attached hereto, or record it on the prescription or discharge summary (in paper or electronic form) for the patient (collectively referred to as the Follow-up Appointment Form).

2. The paper Follow-up Appointment Form must bear the stamp of the healthcare facility in the upper left corner and the signature of the treating physician. The electronic Follow-up Appointment Form must have the digital signature of the treating physician. Each Follow-up Appointment Form can only be used once.

3. The healthcare facility shall record the content and schedule of the rescheduled appointment in the follow-up appointment logbook or in the electronic data of the healthcare facility for tracking and verification when necessary.

4. The patient is responsible for attending the healthcare facility at the time specified on the Follow-up Appointment Form. If the patient cannot attend at the scheduled time, they must contact the treating physician or the healthcare facility to arrange another suitable appointment.

5. The number of rescheduled appointments shall be carried out according to professional requirements after each medical examination and treatment session. A rescheduled appointment may only be made once after the completion of a treatment cycle.

Article 12. Medical Records Transfer to Another Healthcare Facility

1. In cases where a patient is transferred to another healthcare facility providing health insurance medical services according to professional requirements, the transferring healthcare facility must issue a Medical Record Transfer Form to the receiving healthcare facility in accordance with the model prescribed in Appendix VI attached hereto, either in paper or electronic form. The Medical Record Transfer Form is valid for use within 10 working days from the date of issuance.

2. Patients participating in health insurance who suffer from diseases, disease groups, and cases prescribed in Appendix III attached hereto may use the Medical Record Transfer Form which is valid for one year from the date of issuance. In cases where the validity period of the Medical Record Transfer Form has expired but the patient is still undergoing treatment at the healthcare facility and requires continued treatment, the Medical Record Transfer Form remains valid until the end of that treatment cycle.

3. In cases where a patient is transferred to another healthcare facility with additional diseases not listed on the Medical Record Transfer Form, the receiving healthcare facility shall provide medical examination and treatment for those diseases based on the patient's condition and the professional capabilities and scope of activities of the healthcare facility.

4. In cases where a patient is transferred to another healthcare facility and requires multiple treatment cycles according to professional requirements, the patient may continue to use the Medical Record Transfer Form until the end of treatment. After the first treatment cycle, each subsequent treatment cycle must have a Follow-up Appointment Form issued by the healthcare facility to which the patient was transferred. For example, if a patient is transferred to another healthcare facility for eye surgery and needs two treatment cycles for each eye, the patient may use the Medical Record Transfer Form until the end of both treatment cycles.

5. In cases where a patient is transferred to another healthcare facility or the patient visits a healthcare facility that is not the initial health insurance medical service provider and is subsequently transferred to another healthcare facility, only the Medical Record Transfer Form issued by the healthcare facility directly transferring the patient is required.

Article 13. Amending and supplementing certain provisions related to levels and categories in Circulars issued by the Minister of Health

1. Amending and supplementing certain Articles, Clauses, and Points of Circular No. 09/2019/TT-BYT dated June 10, 2019, of the Minister of Health guiding the examination of conditions for signing contracts for initial health insurance medical examinations and treatments, implementation of clinical services, and direct payment of costs in health insurance medical examinations and treatments as follows:

a) Amending the phrase "except in cases where patients go to seek medical treatment at a non-designated level" stipulated in Point a, Clause 1, Article 4 to read "except in cases where patients go to seek medical treatment outside the regulations set forth in Article 26 and Article 27 of the Health Insurance Law."

b) Amending the phrase "discharge from hospital, transfer to another hospital" stipulated in Point c, Clause 1, Article 4 to read "completion of treatment, transfer to another medical examination and treatment facility."

2. Amending and supplementing the phrase "district level" stipulated in Article 1 of Circular No. 35/2021/TT-BYT dated December 31, 2021, of the Minister of Health amending and supplementing Clause 1, Article 9 of Circular No. 30/2020/TT-BYT dated December 31, 2020, of the Minister of Health detailing and guiding measures to implement certain provisions of Decree No. 146/2018/NĐ-CP dated October 17, 2018, of the Government detailing and guiding measures to implement certain provisions of the Health Insurance Law to read "basic medical examination and treatment level."

3. Amending and supplementing certain Articles and Clauses of Circular No. 36/2021/TT-BYT dated December 31, 2021, of the Minister of Health on medical examinations and treatments and payment of costs for health insurance medical examinations and treatments related to tuberculosis medical examinations and treatments as follows:

a) Amending and supplementing the phrase "transfer to a higher-level health insurance medical examination and treatment facility" stipulated in Point c, Clause 1, Article 2 to read "transfer to another health insurance medical examination and treatment facility."

b) Amending and supplementing the phrase "transfer from a higher-level facility" stipulated in Point b, Clause 5, Article 14 to read "transfer from a basic-level or specialized-level medical examination and treatment facility."

4. Supplementing the following provision at the end of Point d, Clause 1, Article 2 of Circular No. 20/2022/TT-BYT dated December 31, 2022, of the Minister of Health promulgating the List and Proportions, Conditions for Payment of Chemical Drugs, Biological Products, Radioactive Medicines, and Markers within the Scope of Benefits for Health Insurance Participants:

"- In cases where medical examination and treatment facilities obtain their first operating permit from January 1, 2025, and during the temporary period of being classified as a basic level according to Clause 7, Article 61 of Decree No. 96/2023/NĐ-CP, they will temporarily apply the regulations for Level II hospitals until the Minister of Health issues new regulations on the list and proportions, conditions for payment of chemical drugs, biological products, radioactive medicines, and markers within the scope of benefits for health insurance participants that replace Circular No. 20/2022/TT-BYT dated December 31, 2022, of the Minister of Health."

Article 14. Responsibility for implementation

1. The Health Insurance Department under the Ministry of Health shall be responsible for leading, coordinating with relevant agencies and units to guide, organize the implementation, inspect the implementation of the provisions of this Circular nationwide; review and propose adjustments to the list of diseases in accordance with the technical capacity of each level and practical requirements.

2. The Department of Health shall have the following responsibilities:

a) Directing, organizing the implementation, guiding, inspecting, and supervising the implementation of the provisions of this Circular for health insurance medical examination and treatment facilities under its management.

b) Announcing the list of initial health insurance medical examination and treatment facilities in the locality, the number of health insurance cards allocated to initial health insurance medical examination and treatment facilities, and the list of medical examination and treatment facilities ranked by the Department of Health along with the points on the Department of Health's website and the medical examination and treatment activity management information system.

c) Advising the People's Committee of the province on ensuring resources and directing the connection and sharing of data on health insurance medical examinations and treatments and payment of costs for health insurance medical examinations and treatments between medical examination and treatment facilities and social insurance agencies on the Department of Health's website in accordance with the law.

d) Guiding the transfer of patients among medical examination and treatment facilities for health insurance participants in the province to meet professional requirements and actual conditions of the locality while facilitating patients.

3. Medical examination and treatment facilities shall have the following responsibilities:

a) Organizing the full and timely implementation of the provisions of this Circular.

b) Ensuring all conditions for health insurance medical examinations and treatments according to health insurance medical examination and treatment contracts, the provisions of this Circular, and laws on medical examinations and treatments and health insurance.

c) Publicizing the results of technical specialty ranking along with the points on the facility's website and at patient reception areas.

d) Advising and guiding health insurance participants about the diseases that can be treated at basic and specialized medical examination and treatment facilities without the need to follow the transfer procedures specified in this Circular when patients come directly for medical treatment to ensure their rights.

e) Training, guiding, and instilling healthcare professionals and medical staff on how to record disease codes and names in accordance with the provisions of this Circular.

Article 15. Effective Date

1. This Circular shall take effect from January 1, 2025.

2. Health insurance participants who have registered for initial health insurance medical examinations and treatments at the facility listed on their health insurance card before the effective date of this Circular shall continue to receive initial health insurance medical examinations and treatments at that facility until there is a change in their registration for initial health insurance medical examinations and treatments in accordance with the guidance in this Circular.

3. Abolishing the following documents and regulations from the effective date of this Circular:

a) Circular No. 40/2015/TT-BYT dated November 16, 2015, of the Minister of Health guiding the registration for initial health insurance medical examinations and treatments and the transfer to higher-level health insurance medical examinations and treatments.

b) Article 6 of Circular No. 30/2020/TT-BYT dated December 31, 2020, issued by the Minister of Health, detailing and guiding measures to implement certain provisions of Decree No. 146/2018/NĐ-CP dated October 17, 2018, issued by the Government, detailing and guiding measures to implement certain provisions of the Health Insurance Law;

c) Articles 3, 4 and Clause 2 of Article 5 of Circular No. 36/2021/TT-BYT dated December 31, 2021, issued by the Minister of Health, on medical examination and treatment and payment of costs for medical examination and treatment under health insurance related to tuberculosis medical examination and treatment;

4. In cases where the referenced documents in this Circular are replaced or amended, they shall be implemented according to the replaced or amended documents;

5. Transitional provisions:

a) Individuals participating in health insurance who come to medical facilities for medical examination and treatment before the effective date of this Circular and complete their medical examination and treatment sessions after the effective date of this Circular shall be governed by the provisions of this Circular;

b) The allocation of health insurance cards to medical facilities and individuals participating in health insurance who have registered for initial medical examination and treatment at such facilities before the effective date of this Circular shall continue until the Department of Health announces the number of health insurance cards allocated to each initial medical facility. The Department of Health shall notify the preliminary registration numbers at each facility no later than July 1, 2025; changes in initial registration for individuals participating in health insurance at these medical facilities shall be allowed until December 31, 2025. For patients currently undergoing treatment at initial medical facilities, the process shall continue until the end of their treatment period;

c) Appointment slips and referral letters issued before the effective date of this Circular shall remain valid until their expiration date as stipulated in this Circular. In cases where referral letters expire from January 1, 2025, but patients are still receiving treatment at medical facilities, such referral letters shall remain valid until the end of their treatment period;

d) Where disease codes in the lists attached to this Circular are replaced by other documents, the new codes shall apply, except when the disease code is canceled without an equivalent replacement code;

đ) Health insurance appointment slips and referral letters prescribed in Decree No. 146/2018/NĐ-CP, amended by Decree No. 75/2023/NĐ-CP, shall continue to be used until the Vietnam Social Security and medical facilities complete the update and submission of data for health insurance medical examination and treatment cost payments according to the Rescheduling Appointment Form and Referral Form for Health Insurance Medical Examination and Treatment prescribed in this Circular, but not later than December 31, 2025. During the implementation process, if there are difficulties or obstacles, relevant agencies, organizations, and individuals shall report them to the Ministry of Health for consideration and resolution;

During the implementation process, if there are difficulties or obstacles, relevant agencies, organizations, and individuals shall report them to the Ministry of Health for consideration and resolution./.